Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Note: The CDC lists ~413,000 Massachusetts residents (12.3% of the total fully vaccinated) whose county of residence is unknown.
For Massachusetts, it's important to note several things: First, every county in the state voted for Joe Biden by a wide margin (Bristol is the closest thing the state has to a "swing district").
Second, there's very little variance in vaccination rates between them as of today...with two weird exceptions: Barnstable and Dukes/Nantucket...in which, according to the CDC, only 4% and 2% of residents have been vaccinated to date, which makes zero sense whatsoever.
I know that Dukes & Nantucket are often merged for purposes of county-level data, and have a far lower combined population than the rest of the state, so I assume there's some unusual "county classification" going on there, or that the residents are reported as residing elsewhere or something. I don't know what the deal is with Barnstable, however.
Combine this with the unusually high "unknown" vaccination rate (no other state I've seen so far has had more than half as many in that category) and I'm not sure what to make of Massachusetts.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Here's Louisiana (reminder: Louisiana calls them Parishes, not Counties):
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Delaware, Hawaii and Rhode Island only have 3, 6 and 5 counties respectively, so it seemed a little silly to run separate graphs for each one (I was already pushing it by giving Connecticut (8 counties) its own entry). So...I've merged all three onto one graph.
It also seemed a bit disingenous to try and come to any conclusions about a trendline with these three states in particular, so I didn't bother (not that there's much to make of that anyway...every county in these states is running between 40 - 65% vaccinated, and within 30-55% Trump support...except for tiny Kalawao, Hawaii, which only has 86 residents (none of whom appear to have been vaccinated yet, according to the CDC?), which I didn't bother listing at all.
Anyway, I'm including them mostly for completeness sake.
2020 Presidential Election results via DE, HI & RI Secretary of State's office (thru Wikipedia)
Earlier today I wrote about the imminent final passage of Colorado's much-ballyhooed "Colorado Option" bill to create a quasi-public option at the state level. If that happens, it would make Colorado the second state to implement such a system.
At the same time, however, Nevada is also in the process of moving their own Public Option bill through the state legislature. I honestly haven't been keeping track of this one lately (there's a lot of healthcare happenings to keep abreast of, folks!), but it sounds like a pretty big deal.
While (assuming it gets passed, signed and implemented) it won't have the bragging rights of being either the first or even second state to do so, it should have a much more important claim to fame: The first true state-level Public Option. As the great Louise Norris notes:
I say "quasi-" because, similar to Washington's, Colorado's proposal isn't a "true" public option in the sense that the state itself would be administering a healthcare program by dealing directly with hospitals, doctors, drugmakers and clinics.
Instead, like WA's "Cascade Care" program, the state would instead design the parameters and requirements of the healthcare policies in question, but they would actually be administered by private insurance carriers and sold on the state's ACA exchange, Connect for Health Colorado. While it's hardly ideal, it would still be an important step forward.
The American Rescue Plan provides new and expanded financial help that dramatically lowers health insurance premiums for people who purchase health insurance through Covered California.
An estimated 272,000 people in the Sacramento, Stockton and Modesto region – including the uninsured and people currently enrolled directly through a health insurance carrier – stand to benefit from the new financial help that is now available.
In order to maximize their savings, consumers need to enroll by May 31 so they can begin saving and benefiting from the new law on June 1.
Many people will be able to get a high-quality plan for as little as $1 per month, and currently insured consumers could save hundreds of dollars per month on their coverage if they switch to Covered California.
The American Rescue Plan provides new and expanded financial help that dramatically lowers health insurance premiums for people who purchase health insurance through Covered California.
Hundreds of thousands of people in the Inland Empire, including the uninsured and people currently enrolled directly through a health insurance carrier, stand to benefit from the new financial help that is now available.
In order to maximize their savings, consumers need to enroll by May 31 so they can begin saving and benefiting from the new law on June 1.
Many people will be able to get a high-quality plan for as little as $1 per month, and currently insured consumers could save hundreds of dollars per month on their coverage if they switch to Covered California.
The American Rescue Plan provides new and expanded financial help that dramatically lowers health insurance premiums for people who purchase health insurance through Covered California.
More than 136,000 people in the Central Valley, including the uninsured and people currently enrolled directly through a health insurance carrier, stand to benefit from the new financial help that is now available.
In order to maximize their savings, consumers need to enroll by May 31 so they can begin saving and benefiting from the new law on June 1.
Many people will be able to get a high-quality plan for as little as $1 per month, and currently insured consumers could save hundreds of dollars per month on their coverage if they switch to Covered California.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know.)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 188 swing districts (out of over 3,100 total), with around 33.8 million Americans out of 328 million total (50 states + DC), or roughly 10.2% of the U.S. population.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Tuesday, May 25th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
As of today, more than 50% of all U.S. adults are fully vaccinated against COVID-19, which is a fantastic milestone to have reached this quickly.
HOWEVER...over 23,000 Americans are still testing positive for COVID-19 every day, and over 450 are dying of it every day.
If you're not vaccinated, GET VACCINATED AND KEEP WEARING A MASK UNTIL 2 WEEKS AFTER YOUR SECOND SHOT.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
NOTE: I've recently updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.
Nearly 1 out of every 7 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 to date.
More than 1 out of every 8 residents of Iowa.
More than 1 out of every 9 residents of Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.
More than 1 out of 10 in New Jersey, Indiana, Delaware, Alabama, Illinois, Florida, Mississippi, Kansas, New York, Minnesota, Georgia, Idaho, Nevada, Wisconsin, Wyoming, Montana,Texas,Kentucky, Louisiana and Massachusetts.
More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.
Last week I got a little ahead of myself by attempting to run a scatter plot displaying current COVID-19 vaccination rates across every COUNTY nationwide according to the 2020 election results...all 3,100+ of them.
But more than two in five Republicans said they would avoid getting vaccinated if possible, suggesting that President Biden has not succeeded in his effort to depoliticize the vaccines — and leaving open the question of whether the country will be able to achieve herd immunity without a stronger push from Republican leaders to bring their voters on board.
New benefits make health insurance more affordable for more Minnesotans
MNsure enrollees are saving almost 20% each month on health insurance plans
ST. PAUL, Minn.—Minnesotans purchasing health insurance through MNsure are seeing increased savings thanks to recent changes to the Affordable Care Act made through the American Rescue Plan. MNsure is reminding Minnesotans in need of health insurance that they can sign up for coverage today through July 16 through the marketplace’s special enrollment period.
“The new and expanded financial help available only through MNsure can help lower the cost of health insurance by hundreds or even thousands of dollars a year for Minnesota families,” said MNsure CEO Nate Clark. “On average, Minnesotans who already have a plan through MNsure are seeing their monthly premiums reduced by almost 20%, which means you can have the peace of mind that comes with having health insurance, while keeping more money in your pocket.”
Unlike most states which kept their 2021 COVID Special Enrollment Period running continuously while they transitioned to the newly-expanded ACA subsidies, Access Health CT took a 2-week break in order to retool their website for the enhanced financial assistance.
The vaccination levels for each state below are based on taking the total number of COVID-19 doses administered to date according to the Centers for Disease Control), then and dividing that into double the state population (since each person needs two doses to be fully vaccinated) as of April 2020 according to the U.S. Census Bureau.
I then adjust each state by counting the single-dose Johnson & Johnson vaccine twice (since it's effectively similar to getting 2 Pfizer or Moderna doses).
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
IMPORTANT UPDATE: It turns out I had Alaska's "boroughs" and "census areas" (not counties) completely botched in several ways. On top of having some names/populations wrong, it also turns out that one of the "census areas" doesn't even exist anymore...it was abolished and split into two new census areas.
The entire post and graphs below have been updated/corrected to reflect this.
UPDATE 6/03/21: I've updated the graphs and table below and am not using fully-vaccinated residents only in order to make Alaska consistent with every other state.
It's also worth noting that the CDC says around 2.9% of all fully vaccinated AK residents (7,900 people) have an unknown home borough/area.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
UPDATED 5/29/21: In addition to updating the data as of 5/29, I've also changed the Y-Axis scale to match every other state (it now runs from 0 - 70% for consistency).
Massachusetts Health Connector and member carriers agree to carry over out-of-pocket costs for mid-year moves to access new lower premiums on-exchange
Agreement allows carrier members to access to lower Health Connector premiums as a result of the American Rescue Plan without resetting deductibles in 2021
May 20, 2021 – All nine health insurance carriers who participate in the Massachusetts Health Connector have agreed to let their off-exchange members move from an off-exchange plan to an exchange-based plan mid-year without losing spent out-of-pocket costs in 2021. This flexibility can help Massachusetts residents access new lower-cost plans through the Health Connector.
Covered California’s Enrollment Surges as People Sign Up to Benefit From the New Financial Help and Lower Premiums Now Available Through the American Rescue Plan
More than 76,000 people signed up for health insurance during Covered California’s special-enrollment period between April 12 and May 15.
The surge is more than 2.5 times higher than a traditional special-enrollment period, reflecting an increase of more than 46,000 people, compared to the same time period in 2019.
Covered California launched a special-enrollment period to allow the uninsured and those enrolled directly through a health insurance carrier to enroll and benefit from lower premiums due to the American Rescue Plan.
More than half of the Covered California households which are benefiting from the new and expanded financial help provided by the American Rescue Plan are getting high-quality coverage for $1 per month.
In order to start saving, Californians need to enroll by May 31 so they can begin benefiting from the new law on June 1.
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan. Here's California, and it's pretty eye-opening.
The original version (with the incorrect New Hampshire data) went somewhat viral on Twitter; it's racked up over 12,000 Likes and thousands of retweets as of this writing.
Here's what it looked like after I made a couple of corrections (particularly New Hampshire, which had some data reporting glitches which have since been worked out):
Nevada Health Link Saves Thousands of Nevadans Money Through 2021 Special Enrollment Periods
CARSON CITY, Nev. (May 17, 2021) –Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), has enrolled more than 7,600 Nevadans since the implementation of two Special Enrollment Periods in 2021, including more than 4,500 enrollees since April 20, attributed to the American Rescue Plan Act (ARPA or American Rescue Plan).
The American Rescue Plan, which was signed into law on March 11, provides Nevadans with a Special Enrollment Period where insured and uninsured Nevadans can take advantage of new, drastically reduced insurance premiums from now until August 15.
But more than two in five Republicans said they would avoid getting vaccinated if possible, suggesting that President Biden has not succeeded in his effort to depoliticize the vaccines — and leaving open the question of whether the country will be able to achieve herd immunity without a stronger push from Republican leaders to bring their voters on board.
Huh. Vermont's ACA exchange website, Vermont Health Connect, has looked pretty much the same for at least the past 5-6 years, but a month or so ago they quietly overhauled the layout & design interface of the site. I have no idea if they actually updated the back-end, however.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
NOTE: I've recently updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.
Nearly 1 out of every 7 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 to date.
More than 1 out of every 8 residents of Iowa.
More than 1 out of every 9 residents of Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.
More than 1 out of 10 in New Jersey, Indiana, Delaware, Alabama, Illinois, Florida, Mississippi, Kansas, New York, Minnesota, Georgia, Idaho, Nevada, Wisconsin, Wyoming, Montana,Texas and Kentucky.
More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.
The vaccination levels for each state below are based on taking the total number of COVID-19 doses administered to date according to the Centers for Disease Control), then and dividing that into double the state population (since each person needs two doses to be fully vaccinated) as of April 2020 according to the U.S. Census Bureau.
I then adjust each state by counting the single-dose Johnson & Johnson vaccine twice (since it's effectively similar to getting 2 Pfizer or Moderna doses).
UPDATE 5/21/21: The first few times I did this, I estimated J&J at 3.5% for every state; since then I've found that the CDC does provide the exact number of each type of vaccine for every state...it ranges from as low as 1.9% in Hawaii to as high as 6.5% in Maine, which is kind of interesting. The later graphs at the bottom have been adjusted to reflect this.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Friday, May 14h, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
I haven't really been following the saga of Colorado's H.B. 1232 "Standardized Health Benefit Plan Colorado Option" bill as much as I should have been over the past year. The last time I wrote anything substantive about it was over a year ago...in fact, it was just a few weeks before the COVID hit the fan:
The issuers will offer the plans on and off the Exchange in the individual market.
The issuers will offer qualified health plans (QHPs) at Bronze, Silver, and Gold metal tiers.
The premiums of the plans will reflect facility reimbursement levels that vary by facility. The formula for determining facility-specific reimbursement levels was provided by DOI, utilizing hospital specific financial information provided by HCPF. Maximum reimbursement levels by facility are set between 155% and 218% of Medicare payment rates.
The plans will be offered beginning in calendar year 2022.
The state intends to apply for a 1332 waiver and use Federal pass-through savings for additional benefits or expanded coverage. The Baseline scenario presented below reflects the current federal and state regulatory market, including a state-based reinsurance program. The second scenario reflects the results of offering a Colorado Health Insurance Option with additional benefits, a premium wrap and a cost-sharing wrap.
Federal health officials on Thursday advised Americans who are fully vaccinated against the coronavirus that they could stop wearing masks or maintaining social distance in most settings, the clearest sign yet that the pandemic might be nearing an end in the United States.
The new recommendations from the Centers for Disease Control and Prevention caught state officials and businesses by surprise and raised a host of difficult questions about how the guidelines would be carried out. But the advice came as welcome news to many Americans who were weary of restrictions and traumatized by the past year.
“We have all longed for this moment,” Dr. Rochelle P. Walensky, the C.D.C. director, said at a White House news conference on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”
It's important to note that "in most settings" caveat:
UPDATE 5/17/21: (sigh) Never mind...again. There were several opinions announced this morning but the ACA case wasn't among them...again. The Sword of Damocles continues to dangle.
UPDATE 5/21/21: Annnnnnd the Supreme Court website now shows more decisions to be announced this Monday, May 24th...here we go again (maybe)...
UPDATE: 5/24/21: (sigh) Never mind...again. There were two opinions announced this mroning but the ACA case wasn't among them...again. The Sword of Damocles continues to dangle.
UPDATE: 5/25/21: Annnnnnnd the Supreme Court website now shows more decisions to be announced this Thursday, May 27th...
Over at the New York Times, Sarah Kliff and Margot Sanger-Katz have written an excellent summary of the problem and the proposed solution:
Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay.
Becerra Pressed On Surprise Billing, Short-Term Plans, Medicare
Lawmakers from both parties pressed HHS Secretary Xavier Becerra over surprise billing implementation, Medicare policy and non-ACA-compliant plans, including the Trump-era short-term plans and Association Health Plans during a wide-ranging hearing on the department’s fiscal 2022 discretionary budget. The former congressman and California attorney general also assured GOP lawmakers that Medicare for All is not on the agenda.
...The House Progressive Caucus has called for the potential $456 billion in savings to be used to add benefits to Medicare, although the caucus also supports making permanent the ACA’s enhanced tax credits. The White House also made clear that it wants the ACA tax credits to remain.
Molina exchange business grew by 302,000 consumers to reach a total 620,000 enrollees in the first quarter, outpacing the company’s earlier 500,000 estimate, growth that CEO Joseph Zubretsky says was driven by strong product design and pricing, higher effectuation rates, lower attrition and the special open enrollment period.
Molina’s marketplace business had a Medical Loss Ratio of 77.3%, which was due to the higher-than-expected direct COVID-related costs as cases surged in many areas.
There's a lot packed into that first paragraph.
First, their ACA enrollment (which presumably includes off-exchange) for Q1 was 24% higher than expected, which is quite an eye-opener.
Florida accounts for nearly one-third of the country’s new Obamacare sign-ups
Florida leads the country in new Obamacare sign-ups during an ongoing six-month special enrollment period announced by President Joe Biden shortly after he took office.
The state saw 264,088 new people enroll in the healthcare.gov marketplace between Feb. 15 and April 30, higher than the number of new enrollees during the shorter enrollment periods of 2020 and 2019 combined, the White House told McClatchy on Tuesday. Florida accounts for nearly a third of all new enrollees so far this year in the entire country.
Most of the article is just a general overview of how the ongoing COVID-19 Special Enrollment Period is doing, but there's two major problems with it.
Several fellow health wonks have chimed in. I spitballed perhaps 95%. Fann puts it at 96-97%. Cynthia Cox of the Kaiser Family Foundation thinks it could be even higher:
The Biden administration said Monday it will provide protections against discrimination in health care based on gender identity and sexual orientation, reversing a policy of its predecessor’s that had been a priority for social conservatives and had infuriated civil liberties advocates.
The reversal is a victory for transgender people and undoes what had been a significant setback in the movement for LGBTQ rights.
The shift pertains to health-care providers and other organizations that receive funding from the Department of Health and Human Services. Civil rights groups had said the Trump administration policy would allow health-care workers and institutions, as well as insurers, to deny services to transgender individuals.
The reversal is the latest step Biden officials are taking to reorient the federal government’s posture on health care, the environment and other policy areas away from the conservative cast of the Trump era, replacing it with a more liberal stance.
Medicaid expansion will not happen in Wyoming this year.
The state’s Senate Labor, Health and Social Services Committee killed a bill Wednesday morning to expand the federal insurance program, which would have insured an estimated 25,000 additional Wyomingites.
Lawmakers have defeated similar proposals for nearly a decade. Advocates hoped this year might be different. Many House Republicans voiced a change of heart after the COVID-19 pandemic and the decline of fossil fuels rocked the state’s economy, leaving many without health coverage. This session was the first in which a bill to expand the program passed a legislative chamber.
Pam MacEwan, CEO Washington Health Benefit Exchange (Exchange), issued the following statement today after the signing of Cascade Care 2.0 into state law:
“Today’s signing of the Cascade Care 2.0 bill sets the stage to improve the quality, availability, and affordability of the health plans offered through Washington Healthplanfinder.
“This bill establishes a state premium assistance program that will benefit over 100,000 low-income Washingtonians struggling to pay for health insurance; increases statewide availability of the state’s first-in-nation public option program; and builds on the success of the high-quality Cascade Care standard plans – that have created average savings of $1,000 in out-of-pocket costs.
Exclusive: Official 2021 #ACA Open Enrollment Period Hits 12.0 Million QHPs For First Time Since 2017
At the time I only had estimated 2021 Open Enrollment Period (OEP) data for several states, but my estimate was confirmed a couple of weeks ago when the Centers for Medicare & Medicaid Services (CMS) issued the official 2021 OEP report, which states that the official total number of ACA Qualified Health Plan (QHP) selections for 2021 was 12,004,365 people.
But more than two in five Republicans said they would avoid getting vaccinated if possible, suggesting that President Biden has not succeeded in his effort to depoliticize the vaccines — and leaving open the question of whether the country will be able to achieve herd immunity without a stronger push from Republican leaders to bring their voters on board.
I ran these numbers last month in my write-up speculating about the prospect of Democrats and the Biden Administration effectively "federalizing" ACA Medicaid expansion altogether by raising the FMAP threshold from 90% to 100%, but it's worth a standalone blog post as well.
The Kaiser Family Foundation estimates that nearly 2.2 million Americans currently fall into the "Medicaid Gap" in the 12 states which haven't expanded Medicaid under the Affordable Care Act yet. They also estimate that another 1.8 million uninsured Americans are eligible for subsidized ACA exchange plans who would be eligible for Medicaid instead if those state actually did expand Medicaid. That's nearly 4.0 million total.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
NOTE: I've recently updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.
Nearly 1 out of every 7 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 to date.
More than 1 out of every 9 residents of Iowa, Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.
More than 1 out of 10 in New Jersey, Indiana, Delaware, Mississippi, Kansas, Alabama, Illinois, Florida, New York, Georgia, Idaho, Wisconsin, Nevada, Minnesota, Wyoming, Montana and Texas.
More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.
A few days ago, the Centers for Medicare & Medicaid Services (CMS) posted an updated report on the number of Americans who have selected Qualified Health Plans (QHPs) through HealthCare.Gov, which hosts ACA enrollment for 36 states during the ongoing COVID Special Enrollment Period (SEP) which began on February 15th and is set to continue through August 15th in most states.
In addition to the 940,000 QHPs via the federal exchange (HC.gov) from 2/15 through 4/30, I've compiled officlal SEP enrollment numbers for several of the states which operate their own ACA exchanges as well:
Colorado: 17,282 from 2/08 - 5/05
Connecticut: 5,890 from 2/15 - 4/15
Idaho: 3,600 from 3/01 - 3/31
Maryland: 15,150 from 1/01 - 2/28
Minnesota: 2,285 from 2/16 - 3/09
Nevada: 6,908 from 2/15 - 5/06
Pennsylvania: 11,126 from 2/15 - 3/25
Washington: 1,700 from 2/15 - 2/23
The total of these, plus the 940,000 via HC.gov, comes to 1,003,516 confirmed so far.
There's no formal press release yet, but I've confirmed that the Nevada Health Link ACA exchange has enrolled 6,908 additional Nevadans in ACA exchange coverage via the COVID Special Enrollment Period as of yesterday (5/06) so far.
This breaks out to around 85 per day from 2/15 - 5/06.
Unfortunately, I don't have Nevada's 2019 or 2020 SEP enrollment handy for comparison, but NV's statewide population (3.10) is right in between Arkansas (3.03 million) and Iowa (3.19 million), which at least allows for a rough comparison:
This strongly suggests that Nevada's 85/day average is perhap 2.5x higher than 2019 and perhaps twice as high as 2020, although 2020 is a fuzzier comparison since HC.gov didn't have a COVID SEP last year while the Nevada Health Link did.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, May 6th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
DENVER — 17,282 Coloradans have signed up for a health insurance plan since Connect for Health Colorado re-opened enrollment on Feb. 8, with more than 7,500 sign ups in the last month alone. That uptick in enrollments coincides with the date that Connect for Health Colorado began offering increased savings on health insurance to residents of all income ranges following the passage of the American Rescue Plan.
Hmmm...I know they say "7,500 in the past month", but they reported 9,971 as of 4/07, so that should mean 7,311 in the past month. Huh.
Washington Health Benefit Exchange Opens the Doors for Washingtonians to Benefit from Lower Health Care Premiums and Save Money Through the American Rescue Plan
More Than $250 Million in Tax Credits Available to Help Washingtonians Lower Health Insurance Costs
Health coverage purchased on Washington Healthplanfinder became much more affordable today as the Washington Health Benefit Exchange (Exchange) rolled out new savings to help Washingtonians with the cost of their individual health insurance.
Overall, enrollment during the 2021 COVID SEP is up 3.5x vs. the same time period in 2019, which makes sense when you consider a) the COVID pandemic which has caused millions to lose their income and/or employer-based healthcare coverage; b) the "fully open" status of the COVID SEP; and c) the expanded subsidies put in place under the American Rescue Plan.
SEP enrollment is also up 2.4x over the same time period in 2020; COVID was in full force for most of that period last year, but HC.gov refused to launch a "wide open" SEP as most of the state-based exchanges did, nor were there any expanded subsidies in place, so 2019 is still the more appropriate year to compare against. (Besides, 2020 was a leap year, which tacked an extra day onto the total).
HHS Secretary Becerra Announces Nearly 940,000 Americans Have Signed Up for Health Coverage through HealthCare.gov During Special Enrollment Period
Since April 1, premiums have been reduced by over 40 percent for nearly 2 million current HealthCare.gov enrollees
Today, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced that nearly 940,000 Americans have signed up for health insurance through HealthCare.gov as a result of the Biden Administration’s Special Enrollment Period (SEP) for the COVID-19 Public Health Emergency. The 2021 SEP, along with the additional financial assistance afforded by the American Rescue Plan (ARP), offers individuals and families an opportunity to take advantage of reduced premiums, increased savings, and quality, affordable health coverage through HealthCare.gov.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
New television ads began airing today in four languages – Mandarin, Cantonese, Korean and Vietnamese – to let California’s Asian Americans know about the new savings provided by the American Rescue Plan.
The new ad campaign coincides with the start of Asian American and Pacific Islander Heritage Month.
More than 400,000 Asian Americans in California, including the uninsured and people enrolled directly through a health insurance carrier, stand to benefit from the new financial help that is now available.
Many Californians will be able to get a high-quality plan for as little as $1 per month, while currently insured consumers could save up to $700 per month on their coverage if they sign up through Covered California.
SACRAMENTO, Calif. — Covered California launched a new television ad campaign on Monday to raise awareness in California’s Asian American community about the new financial help now available through the American Rescue Plan. The ads, which are in Mandarin, Cantonese, Korean and Vietnamese, highlight how 400,000 Asian Americans can now get lower health insurance premiums starting June 1.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
As regular readers know, for over a year now, I've been tracking the spread of COVID-19 per capita case and death rates a) at the county (not just state) level and b) along partisan lines.
The most obvious example of this has been my weekly updated breakout of the RATIO between the case & death rates over time in "Blue Counties" (those won in 2016 by Hillary Clinton, later replaced by those won in 2020 by Joe Biden, by at least 6 points or more) vs. the rates in "Red Counties" (those won by Donald Trump in 2016, late replaced with 2020 results, by 6 points or more).
It's no secret that as a) a lifetime Michigan resident and b) an openly activist Democrat, I'm a huge fan of Michigan Governor Gretchen Whitmer (I was even on a healthcare town hall panel with her back in 2017 during the Repeal/Replace debacle). Having said that, I'm still impressed with the announcement just put out by the MI Dept. of Insurance & Financial Services:
Michigan Insurers on HealthCare.Gov Provide Consumer Flexibility
(LANSING, MICH) Through an agreement announced today between Governor Gretchen Whitmer, the Michigan Department of Insurance and Financial Services (DIFS), and all nine of Michigan’s Marketplace insurers, Michiganders enrolled in a health plan through the Health Insurance Marketplace can now take advantage of expanded tax subsidies offered by the American Rescue Plan without having to restart their deductibles when they switch to another plan offered by their current insurer, and in some cases even if they choose a plan through another insurer.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
Today, Department of Health and Human Services (HHS) Secretary Xavier Becerra kicked off Asian Pacific Heritage Month by announcing that HHS will be partnering with select, national organizations the first week in May to support and enhance outreach and enrollment efforts for this population during the HealthCare.gov Special Enrollment Period (SEP). During the Asian American and Pacific Islander (AAPI) Week of Action, which runs May 3-7, 2021, HHS and partnering organizations will provide education and enrollment assistance to AAPI consumers and use social media to encourage them to enroll in affordable, quality health coverage available through HealthCare.gov.
As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
NOTE: Starting this week, I've updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.
Nearly 1 out of every 7 residents of South Dakota, North Dakota and Rhode Island have tested positive for COVID-19 to date.
More than 1 out of every 9 residents of Iowa, Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.
More than 1 out of 10 in New Jersey, Indiana, Delaware, Mississippi, Kansas, Alabama, Illinois, Florida, New York, Georgia, Idaho, Wisconsin, Nevada, Minnesota, Wyoming and Montana.
More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.
